Understanding interactions between Chinese medicines and pharmaceutical drugs in integrative healthcare / 中国结合医学杂志

In the 21st century, the public are more informed, mainly via the Internet, about health and medical products and have become more knowledgeable about matters relating to their health conditions and well-being in curing and preventing illnesses. They often self-medicate themselves with various health products and over-the-counter (OTC) medicines apart from prescribed pharmaceutical drugs (PD). Some of those non-prescribed products may have doubtful quality control and contain harmful additives or unchecked ingredients; thus their usefulness is in doubt. The increasing popularity world-wide of using Chinese medicines (CM) and related OTC functional products has raised concerns over their concomitant use with PD and the consequential adverse effects. In most cases the alleged causes of adverse effects are linked with herbal sources, although the authorised information on the interactions between CM-PD is not plentiful in the literature. There is an urgent need for such a data base. The future professionals in health and medical care should be knowledgeable or aware of what their patients have been taking or given. In actual practice the patients may receive both treatments intentionally or unintentionally, with or without the awareness of the practitioner. In these situations a reliable database for interactions between CM-PD will be extremely useful for consultation when treatment problems appear or during emergency situations. Their combining of medications may be involved with possible outcomes of adverse reactions or beneficial effects. Such a database will be welcomed by both practitioners of herbal medicines and orthodox medicine practitioners in the emerging trend of integrative medicine. The author has been involved in various research projects of basic and clinical aspects in mainly CM among other herbal and PD. Examples will be given largely on those related to these disciplines as illustrations in this overview.

Determination of free ferulic acid and total ferulic acid in Chuanxiong by high-performance liquid chromatography for quality assessment / 中国中药杂志

Ferulic acid (FA) is one of the main bioactive compounds in Chuanxiong (CX), the dried rhizome of Ligusticum chuanxiong, but its amount in this herb is difficult to determine accurately. An accurate quantificational method was developed to investigate on the available amount of FA (free FA and total FA). Herbal samples were extracted in methanol-formic acid (95:5) and methanol-0.24 mol x L(-1) sodium hydrogen carbonate in water (95:5), respectively and then quantitatively analyzed by HPLC method. Thirty three CX samples were quantified on free and total FA. Total FA was found more abundant than free FA with an average ratio of 2.38 (n = 32) in the range of 1.03- 4.98 in 32 CX herbs, and a highest ratio of 19.6 was estimated in a rhizome seedling. Results showed that total FA content would be a better marker for the quality assessment of CX herbs. Fifteen CX typical samples were collected from the trueborn cultivating areas in Sichuan province of China. The amount of total FA in these herbs was estimated to be 1.42 mg x g(-1) (n = 15). The proposed limit of total FA in CX samples should not less than 1.25 mg x g(-1) calculated on the dried basis. It was also found that the level of total FA was related to the quality, processing method and store duration of CX samples.

Responsiveness of the Chinese Quality of Life Instrument in patients with congestive heart failure / 中国结合医学杂志

<p><b>OBJECTIVE</b>The Chinese Quality of Life Instrument (ChQOL) was developed as a valid generic health status instrument based on the well-established theory of health in Chinese medicine. Psychometric properties of the ChQOL were good. In the present study, the responsiveness of the ChQOL in patients with congestive heart failure (CHF) were investigated and compared with two generic questionnaires, the Medical Outcomes Study Short Form 36-item Health Survey (SF-36) and World Health Organization Quality of Life Assessment (WHOQOL-BREF), as well as one disease-specific questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHF).</p><p><b>METHODS</b>Thirty-nine in-patients with CHF who had undergone treatment with integrative medicine were recruited. The health status measurements were performed at enrolment and after a 4-week treatment. The following responsiveness indices were used: the effect size (ES) and standardized response mean (SRM). All patients were classified into those groups with stable measures and those groups with changes after a 4-week treatment, based upon both the doctor's global rating of changes in heart function tests, and the patient's global rating of changes in overall quality of life.</p><p><b>RESULTS</b>All domains of the ChQOL showed significant improvement. In the comparison of the responsiveness indices, the ChQOL was regarded as more responsive than the WHOQOL-BREF or SF-36 utility, but it was less responsive than the MLHF.</p><p><b>CONCLUSIONS</b>The ChQOL was better in sensitivity and responsiveness for assessing congestive heart failure as a generic measure than the SF-36 and WHOQOL-BREF. The ChQOL is considered suitable as an outcome measure for clinical trials in patients with congestive heart failure.</p>

Application of factor analysis in development and validation of a new questionnaire for quality of life / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the application of factor analysis in creating a new health-related questionnaire for evaluating quality of life, the Chinese for Quality of Life Instrument (ChQOL).</p><p><b>METHODS</b>Two hundred and seventy-three subjects selected from two provinces of North China (Ningxia) and South China (Guangdong) were investigated by ChQOL, and the preliminary version was completed with factor analysis.</p><p><b>RESULTS</b>Fifty items were developed using factor analysis. The final structure model of ChQOL was confirmed through the screening and verification of factor structural model on the 78 items of ChQOL, a new questionnaire with more rational structure was confirmed.</p><p><b>CONCLUSION</b>Factor analysis is an effective method in developing new questionnaire.</p>